Common variable immunodeficiency- A delayed diagnosis of an underdiagnosed entity in resource limited setting

We report a case of common variable immunodeficiency (CVID) in a 42-year-old female who presented with history of recurrent rhinosinusitis for the last ten years. Patient had developed cough and progressive dyspnoea for last one year. Patient was admitted with community acquired pneumonia and sputum culture was positive for Pseudomonas aeruginosa. Common variable immunodeficiency was diagnosed ten years after the onset of symptoms. CVID is an underdiagnosed disorder because of the low index of suspicion, lack of awareness, poor facilities for the investigations and higher prevalence of infectious diseases in developing countries. CVID should be suspected in patients with recurrent rhinosinusitis or pneumonia and evaluation of serum immunoglobulins is advised.